Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-seven SLE patients with severe renal disease characterized by renal biopsy documentation of diffuse proliferative or membranous glomerulonephritis or the nephrotic syndrome have been treated with azathioprine and prednisone in combination and followed for up to 12 years. Survivorship was 82% +/- 6% for five years and 74% +/- 8% for 10 years. There have been eight deaths and two patients have gone on hemodialysis. Five of the eight deaths are attributable to superinfection. Improvement in creatinine clearance was documented in 21 and decreased proteinuria in 35 of the patients. A therapeutic program, which included high dose corticosteroids initially, the combinations of azathioprine with corticosteroids chronically, and the rapid reduction in corticosteroid dosage to an alternate day schedule, appears to contribute to improved survivorship.
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PMID:Longterm survival of lupus nephritis patients treated with azathioprine and prednisone. 37 23

Renal tissues from 37 patients with glomerulopathies involving glomerular crescents were investigated using an immunofluorescence technique. Immunohistologic findings revealed two kinds of crescents, those with fibrinogen deposits (active), and those without (inactive). The degree of IgG deposition in glomeruli with active crescents was much higher than in glomeruli with inactive crescents in acute glomerulonephritis (AGN) and chronic glomerulonephritis (CGN). Active crescents were observed only in biopsy specimens taken within three months after the onset of acute glomerulonephritis or the acute exacerbation of chronic glomerulonephritis. These findings suggest that in AGN and CGN active crescents occur in an earlier stage of glomerular lesions and a more active stage in the immunological process than inactive crescents. The significance of active crescents in SLE, diabetic nephropathy and nephropathy associated with rheumatic arthritis was not evaluated due to the small number of patients.
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PMID:Immunohistologic findings in the glomerular crescents in various renal diseases. 37 95

Antibodies to histones were investigated in the serum of forty-five patients with spontaneously occurring systemic lupus erythematosus (SLE) who were not receiving any form of treatment. Twenty-three had active and twenty-two had inactive disease. Thos with active disease were also studied after the initiation of corticosteroid treatment to determine the effect of treatment on anti-histone antibodies. Both a complement fixation method and indirect immunofluorescence of acid-eluted histone-reconstituted tissue sections were used, with excellent correlation between these two methods. Eleven of the forty-five SLE patients, but none of forty-five normal controls had antibodies to histone. Untreated patients with active and inactive disease had a similar incidence of antibodies to histone. They disappeared, however, soon after the initiation of treatment in the patients with active disease. Patients with antibodies to histones had a higher prevalence of cutaneous vasculitis, anaemia, lupus nephropathy and Raynaud's phenomenon, but a lower prevalence of lupus brain involvement than those without such antibodies. Only the latter, however, reached statistical significance.
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PMID:Antibodies to histones in systemic lupus erythematosus. 38 Aug 54

Thirteen patients who had systemic lupus erythematosus were studied for the purpose of correlating the findings of light and electron microscopy and immunofluorescent studies with renal function and the presence of proteinuria. Subendothelial deposits of electron-dense material were found in all biopsy specimens, whereas mesangial and subepithelial deposits were not always present. IgG and beta 1c were constant findings in the glomerular membrane. The seven patients who were found to have extensive subendothelial deposits had moderate to massive proteinuria, and four of these patients had decreases in renal function. Most of the patients who had smaller subendothelial deposits had slight or insignificant proteinuria. Massive subendothelial deposits were mainly found in specimens showing histologic evidence of active lesions. Correlation was also found between proteinuria and the overall amount of deposits and their distribution. The prognosis was dependent on the severity of subendothelial deposits, the overall amount of deposits, and the morphologic form of lupus nephropathy.
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PMID:Lupus nephritis. Electron-dense and immunofluorescent deposits and their correlation with proteinuria and renal function. 38 26

To investigate the suggestion that qualitative immunochemical characteristics of antibodies to DNA (anti-DNA) may be of importance in the pathogenesis of nephritis in systemic lupus erythematosus (SLE), we used the Crithidia luciliae (CL) immunofluorescence test to determine the titre, immunoglobulin (Ig) class and complement-fixing activity of anti-DNA in thirty-five patients with active SLE. Eighteen of these patients had active lupus nephritis (Group I) and the remaining seventeen had no clinical evidence of renal involvement (Group II). Anti-DNA was detected in twenty-eight patients, and was present more frequently and in higher titre (P less than 0.01) in Group I than in Group II. Anti-DNA of all three Ig classes studied (IgG, IgM and IgA) was present in twenty-three out of twenty-eight cases. The ratio of IgG to IgM anti-DNA did not differ in the two groups of patients. Complement-fixing antibodies were detected in thirteen patients in Group I and five patients in Group II. The titre of complement-fixing activity was strongly correlated with titre of anti-DNA. DNA-binding capacity was also determined in these by a millipore filter (MF) assay. A highly significant correlation between DNA binding by MF and CL was found in Group I patients, while no correlation was found in Group II patients. These findings suggest that (1) anti-DNA with specificity for determinants found in CL, presumably native DNA, are more highly correlated with the presence of active renal lupus than are antibodies directed toward other DNA determinants, and (2) the major characteristic of anti-DNA found to be associated with nephritis was quantity of antibody. Most patients had anti-DNA of all Ig classes regardless of the presence of renal disease. Complement-fixing activity of anti-DNA could not be related to the occurrence of renal disease independently of anti-DNA titre.
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PMID:Immunochemical characteristics of antibodies to DNA in patients with active systemic lupus erythematosus. 38 88

One male and seven female patients (aged 6 to 26 years) with systemic lupus erythematosus (SLE), normal urinalyses, and normal biochemical tests of renal function, had renal biopsies to determine if significant nephropathy existed. Several had active SLE in other body systems at the time, either clinically or as evidenced by low serum complement and high native DNA antibody levels. The renal biopsy specimens were studied by light, fluorescent antibody, and electron microscopy. Three patients had a generalized segmental, two had a focal segmental, and one had a generalized diffuse proliferative glomerulonephritis. In addition, one patient had minimal glomerular findings with interstitial inflammation. All eight patients were found to have moderate immune complex deposition by immunofluorescence and/or electron microscopy studies. The absence of clinical renal involvement in patients with SLE does not preclude ongoing active and "silent" glomerular damage with moderately severe proliferative changes.
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PMID:Nephritis in children and young adults with systemic lupus erythematosus and normal urinary sediment. 38 41

The clinical and renal histologic attributes of 135 systemic lupus erythematosus (SLE) patients with DNA and/or Sm antibodies were compared to determine if the presence of the Sm antibodies served as a marker for a specific subset of SLE. Although Raynaud's phenomenon was more frequent in patients with Sm antibodies (P less than 0.005), serious central nervous system disease was over three times as common in patients with DNA antibodies (P less than 0.005). Only one of 23 patients with Sm antibodies had diffuse proliferative glomerulonephritis on renal biopsy, whereas 6 of 14 patients with only DNA antibodies had this histologic finding (P = 0.01). The Sm antibody system may therefore identify a subset of SLE patients with milder central nervous system and renal disease.
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PMID:Identification of a clinical subset of systemic lupus erythematosus by antibodies to the SM antigen. 39 Dec 37

366 kidney biopsies from 339 patients, 290 of which were classified on combined light microscopy (LM) and clinical criteria as glomerulonephritis (GN) and 49 as non-glomerulonephritis nephropathy, were examined by immunofluorescent microscopy (IFM) without knowledge of the clinical or LM findings at the time of examination. The IFM findings in the glomeruli were correlated to (l) the LM diagnosis, (2) the clinical symptoms, (3) the clinical course, and (4) the effect of immunosuppressive treatment. A few IFM results were found to correlate significantly with the LM diagnosis and clinical symptoms, but not to the effect of immunosuppressive treatment. It was impossible using IFM alone to group patients into any specific categories with uniform symptomatology and prognosis. Defined by IFM "immune complex nephritis" was demonstrated in 72%, and linear nephritis was found in 2% of the patients with GN. IgA occurred more frequently in GN secondary to systemic disease, particularly in SLE (60%) and HSP (88%). IgA was demonstrated in only 10% of patients with nonglomerulonephritic nephropathy. Demonstration of IgA is therefore a good indicator for corroborating the LM diagnoses of GN. Demonstration of IgG and/or IgM in GN was not found to be sufficient evidence for GN because these deposits also appeared in 40% of patients with non-glomerulonephritic nephropathy. An immunopathological classification based solely on glomerular deposits of immunoglobulin/C3 appears to have no practical importance. The demonstration of glomerular deposits of immunoglobulin/C3, however, showed to be a necessary supplement to clinical and morphological findings in some instances, in order to attain practical diagnostic boundaries within the very ill-defined concept which today constitutes GN.
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PMID:Immune deposits in human glomerulopathy. Fluorescent microscopy findings in 366 kidney biopsies correlated to symptoms, clinical course and immunosuppressive therapy. 39 71

A soluble glomerular basement membrane (GBM) antigen was detected in the urines of patients with various glomerular diseases including chronic glomerulonephritis, nephrotic syndrome, chronic renal insufficiency, and lupus nephropathy. The urinary GBM antigen (u-GBM) was immunochemically distinct from other renal antigens and other serum components, but it was cross-reactive with trypsinized human GBM antigen (t-GBM). The molecular size of u-GBM was approximately the same as human serum albumin as estimated by elution patterns on Sephadex G-200. The concentration of u-GBM was estimated quantitatively by a single radial radioimmunodiffusion. Although differed from case to case, a rough correlation with the type and/or stage of nephrotic syndrom existed. It was also demonstrated that the amounts of u-GBM decreased in response to steroid therapy of nephrotic syndrome. It was further shown that in a case of membranoproliferative glomerulonephritis, anti-GBM antibody could be eluted from the kidney removed from the patient. These findings imply that the GBM antigen plays an important role in the pathogenesis of human renal diseases. The pathophysiological significance of urinary GBM excretion in renal diseases is also discussed here.
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PMID:Immunochemical characterization and quantitation of the human glomerular basement membrane antigen from the urine of patients with glomerular diseases. 40 15

Data from a prospective study of the clinical course in 223 patients with systemic lupus erythematosus followed for 655 patient-years were analyzed by computer to determine the influence on frequency of infection of 1) corticosteroid dose; 2) azathioprine; 3) active disease, measured by new disease exacerbations, elevated ESR, hypocomplementemia, active urinary sediment, and proteinuria; 4) uremia; and 5) leukopenia. The frequency of all infections, and of bacterial and opportunistic infections specifically, increased progressively with increasing steroid dose. Azathioprine use, independent of steroid dose, did not account for an increased risk of bacterial, opportunistic, or nonspecific viral infections. Leukopenia did not predispose to infection, except possibly when associated with azathioprine-induced bone marrow suppression. Active renal disease, especially when manifested by abnormal urine sediment, was associated with an increase in infection frequency.
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PMID:Computer analysis of factors influencing frequency of infection in systemic lupus erythematosus. 41 59


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